Search Results - NGSMEDICARE

Posting Date: 04/09/2025

59118

Avoiding/Correcting This Error Review reason code 59118 in the Direct Data Entry system for applicable codes. Alternatively, review the latest Change Requests/MLN® Matters articles for relevant ICD-10 updates. The most current MLN Matters [...]

Posting Date: 04/09/2025

59118

Avoiding/Correcting This Error Review reason code 59118 in the Direct Data Entry system for applicable codes. Alternatively, review the latest Change Requests/MLN® Matters articles for relevant ICD-10 updates. The most current MLN Matters [...]

Posting Date: 04/09/2025

39928

Avoiding/Correcting This Error To access the line level reason associated with this reason code providers should go to claim page (2) (MAP 1712) and F11 to MAP171D to see the line level denial codes for each line of the claim. If you disagree [...]

Posting Date: 04/09/2025

56900

Avoiding/Correcting This Error This reason code can and should be prevented. When providers receive an ADR, respond according to the date listed in the ADR. Providers should start gathering the documentation being requested immediately. This [...]

Posting Date: 04/09/2025

56900

Avoiding/Correcting This Error Regularly access claims in status locations SB6001, SB6098, or SB6099 to obtain a listing of claims for which records have not yet been received by the MAC (Medical Review Department). Look for information on the [...]

Posting Date: 04/09/2025

56900

Avoiding/Correcting This Error Regularly access claims in status locations SB6001, SB6098, or SB6099 to obtain a listing of claims for which records have not yet been received by the MAC (Medical Review Department). Look for information on the [...]

Posting Date: 04/09/2025

5WEXC

Avoiding/Correcting This Error Ensure all Medicare coverage and medical necessity requirements are met prior to billing. When the provider determines that Medicare will not cover the services, consider submitting the charges as noncovered. [...]

Posting Date: 04/09/2025

W7010

Avoiding/Correcting This Error This edit is applied to claims submitted with condition code 21 for an insurance denial. If the services were not meant to be sent for insurance denial, you will need to go through the appropriate [...]

Posting Date: 04/09/2025

W7010

Avoiding/Correcting This Error This edit is applied to claims submitted with condition code 21 for an insurance denial. If the services were not meant to be sent for insurance denial, you will need to go through the appropriate [...]

Posting Date: 04/09/2025

56900

Avoiding/Correcting This Error This reason code can and should be prevented. When providers receive an ADR, respond according to the date listed in the ADR. Providers should start gathering the documentation being requested immediately. This [...]